Jim's SteakOut : Online Job Application

Jim's SteakOut Online job Application!

» The Civil Rights Act of 1964 prohibits discrimination because of race, color, religion, or national origin. Public Law 90-202 prohibits discrimination because of age. the 1990 Americans with Disability Act prohibits discrimination because of disability. Jim's SteakOut is an Equal Opportunity Employer.

General Information:

Today's Date:

First Name, M.I., Last Name:

Social Security #:

Street Address, City, State and Zip:

Phone Number:

Alternate Number:

Referred By:

Which location would you prefer to work at?

Are you under 18 years of age?
Yes No

Are you a U.S. citizen?
Yes No

Have you ever been convicted of a crime? No Yes, please explain:

Position Applying For:

Date You Can Start:

Salary Desired:
per hour.

Have you worked for Jim's SteakOut before
No Yes ... if so, when:

Have you applied to work for Jim's SteakOut before?
No Yes ... if so, when:

Do you have any friends or relatives working at Jim's SteakOut?
If so, who:

Shift you are willing to work? First Second Third

Any special qualifications?

In case of emergency, notify at the following number .

Education:

High School Name:	Location:	Graduated?	Courses Studied:

College Name:	Location:	Graduated?	Courses Studied:

Trade/Other School:	Location:	Graduated?	Courses Studied:

Former Employers:

List your last three employers starting with your last one first.

Dates Worked: Position Held:	Company and Address:	Reason for Leaving: Supervisor's Name:
Dates Worked: Position Held:	Company and Address:	Reason for Leaving: Supervisor's Name:
Dates Worked: Position Held:	Company and Address:	Reason for Leaving: Supervisor's Name:

Personal References:

List three persons not related to you whom you have known at least one year.

1)	Name:	Occupation:
1)	Address:	Phone:
2)	Name:	Occupation:
2)	Address:	Phone:
3)	Name:	Occupation:
3)	Address:	Phone:

Applicant's Agreement
Please read the following statement carefully.

I hereby certify that the facts contained in this employment application are true and complete to the best of my knowledge. I understand that if I am employed, falsified statements or omissions shall be considered sufficient cause for dismissal. I hereby authorize inquiries to my former employers, whose names I gave, to furnish information regarding my work and personal character to this prospective employer.

By checking this box I am stating that I have read and understood the above agreement.